CAJ | 학술논문

目的：比较肝脏增强CT以及肝脏MRI对肝癌合并癌栓临床诊断中的敏感性与准确性。方法临床纳入50例经腹部B超确诊有肝脏中、小型占位病变患者，均进行了肝脏增强CT以及肝脏MRI，并最终经病理学检查确诊为肝癌。以病理学检查作为诊断肝癌的“金标准”。比较CT以及MRI检查对肝癌的诊断价值。结果肝脏增强CT检查与术后病理结果的一致性系数Kappa值为0．327，肝脏MRI检查与术后病理结果的一致性系数Kappa值为0．707，差异有显著性（P＜0．05）；肝脏增强CT检查准确度、灵敏度、阴性预测值分别为74．00％、79．49％、42．80％，肝脏MRI检查准确度、灵敏度、阴性预测值分别为90．00％、94．87％、77．35％，差异有显著性（P＜0．05）。CT与MRI共同检查确诊阳性病例30例，CT检查阳性而MRI检查阴性1例；CT检查阴性而MRI检查阳性4例；CT与MRI检查共同确诊阴性病例8例，差异有显著性（P＜0．05）。结论肝脏MRI在肝癌检出率以及准确率方面均明显高于肝脏增强CT，对于临床上高度怀疑肝癌的患者，可以直接进行肝脏MRI检查；对于CT检查后不能完全排除肝癌的病例，应进行MRI检查。
목적：비교간장증강CT이급간장MRI대간암합병암전림상진단중적민감성여준학성。방법림상납입50례경복부B초학진유간장중、소형점위병변환자，균진행료간장증강CT이급간장MRI，병최종경병이학검사학진위간암。이병이학검사작위진단간암적“금표준”。비교CT이급MRI검사대간암적진단개치。결과간장증강CT검사여술후병리결과적일치성계수Kappa치위0．327，간장MRI검사여술후병리결과적일치성계수Kappa치위0．707，차이유현저성（P＜0．05）；간장증강CT검사준학도、령민도、음성예측치분별위74．00％、79．49％、42．80％，간장MRI검사준학도、령민도、음성예측치분별위90．00％、94．87％、77．35％，차이유현저성（P＜0．05）。CT여MRI공동검사학진양성병례30례，CT검사양성이MRI검사음성1례；CT검사음성이MRI검사양성4례；CT여MRI검사공동학진음성병례8례，차이유현저성（P＜0．05）。결론간장MRI재간암검출솔이급준학솔방면균명현고우간장증강CT，대우림상상고도부의간암적환자，가이직접진행간장MRI검사；대우CT검사후불능완전배제간암적병례，응진행MRI검사。
Objective To observe the sensitivity and accuracy of enhanced CT of and MRI in the clinical diagnosis of liver cancer.Methods 50 cases of patients with medium and small lesion diagnosed by abdominal B ultrasound were selected. All patients were given liver enhanced CT and MRI,and were diagnosed as liver cancer through pathological examination.Patho-logical diagnosis is the“gold standard” of liver cancer.The significance and value of CT and MRI in the diagnosis of liver cancer were observed.Results The consistency coefficient Kappa value of liver enhanced CT and postoperative pathologic result was 0.327,while the consistency coefficient Kappa value of liver MRI and postoperative pathologic result was 0.707.The difference was significant (P <0.05);Predictive accuracy,sensitivity,and negative values of liver MRI were 74.00%,79.49%,and 42.80%,while predictive accuracy,sensitivity,and negative values of liver CT were 90.00%,94.87%,and 77.35%.The differ-ence was significant (P<0.05).30 cases were diagnosed as positive by CT and MRI,1 case was diagnosed as positive by CT,but negative by MRI;4 cases were diagnosed as negative by CT,but positive by MRI;8 cases were diagnosed as negative by CT and MRI.The difference was significant (P<0.05).Conclusion The liver detection rate and accuracy of MRI are higher than liver enhanced CT.For patients with a high clinical suspicion of liver cancer,MRI should be conducted;for patients who cannot be ruled out of liver cancer after CT,MRI should be conducted.